Verification Request Form 

 
If you need a verification of your Nevada license, please complete the form below. A written verification will mailed within 10 business days directly to the state board for which you are requesting the verification.  If the state for which you are requesting the verification has a request form,  then send that form only. Do not complete this request.
*First Name:
*Last Name: 
   		 *Contact Email:
*Nevada License Nunber: 
*To Which State do you need the verification sent?
*Indicates required field
Additional Notes: